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NOV/20/2008/THU 04: 36 PM COS & REDEV FAX No, 2099379 P. 004. 11/20/2006 THU 14: 21 PAX 24463633 SJC EHD 04/006 112�� yr>� 1 UNIFIED PROGRAM CONSOLIDATED B UNDERGROUND STORAGE TANK M96-�3 n,I q OPERATING PERMIT APPLICATION-TANK INFORMATION(one fhrm per UST) TYPBOPACTION (Check one hem only. Foran LIST permanent do4Rreor removal,complete only this Section and Sections 41I IIT,IV,and IX below) 'su ❑ I.NEW PERMIT ❑ 3.RENEWAL PERMIT ❑ •CHANGE OF INFORMATION Cl 4.TEMPORARY UST CLOSURE d 7.UST PERM ENT CLOSUREONS)TE S.UST REMOVAL DATE UST PERMAN YL'LOSFD: U O 41°' DATE EXIST IN OUSTO(SCOVER®- ' N 'aDO 4Ma I..'FACILIIY INFORMATION FACILITY ID 4(Agency Use Only) _ + USINESS NAME(Sameas FACILITY NAME or DBA-Doing Business AS) a BUSRJE55S� tGL N Im C1TY ' IL TANK DESCRIPTION TANK ID °I2 TANK MANUFACTURER 031 TANK CONFIGUMIION:TIUSTANIIS 'N /2 �1�/I' n1.nSTAND-w1ANBTANK /�-,(� [f 2.ONE TNA COMPARTAIEN[ED VMT. Cam mean° r°rr44F ��9lhcvaR. DATE USTSYSTEMMSTALLED 435 TMlK CAP YI LOTS 'w NUMBER OF COMPARTMENTS INTHE UNIT 07 . . . "1'IL TANK''USE:ANU CONTENTS . TANK USE p ta,MOTORVERMLGFUELING ❑ Ib.MARINAPUBUNG U Io.AVIATIONFUCLING 459 03,CHEMICAL PRODUCTSTOMGE Cl DVSWAST6(Wwa0w010 13-IL EMERGBNCYOMERATOR FUEL(HSC92SNIS(dl Q 6.0THERGENERATORI'M 93.UNKNOWN CJ 99.OTHER(SpMib9: ales CONTENTS PETROLEUM: © (a,REGULAR UNMA15ED Q Ir.MR)GMDEUNIbAOEO ❑ 1b.PR Djm UNLRADED Cl 3.DIESEL 05.)Er FUEL 06.AVIATION GAS ❑6.PETROLEUM PLF_ND MEL ❑ 9-OTHER PETROLEUM 44h NON-PETROLEUM: 2USEDOIL 1310,MANOL ❑ [I.OTHER NON-PETROLEUM(Soacift - 01D Iv:.ruviccoNSTxu�rloN ...: TYPEOFTANI LSMOLBWALL 2.000BLEWALL LI 95.UNKNOWN s0 PRIMARY CONTAINMENT I.STEEL U S.FIBERGLASS U 6.1MERNALBLADDER 444 7.5ML,+INTERNAL LINING95.UNKNOWN ❑99.0TNER 44% SPCDNDARYCDNTAINMT I.STREL, 3.FIBERGLASS ❑6.EXTERIOR t•IEMBRANG LINER 7.fAC3CETBD 446 EN ❑9a.NONE ❑1.1- MOWN 99.0 TER IS c ): -°ass OVERPILLPREVENTION ❑ I.AUOIBLS&VISUAL ALARMS 2.BALL PLOAT S.FILL TUBESHUT-OFF VALVE 4sz. Q 4,TANKMEETS UIREMENTS FORE)CGMPNONFROMOVERFRS,PREV ONEpUOMFNI' PRODUCT/WASTE PIPING CONSTRUCTION" - NPINGCONSTRUCTION QI.SMG.E.WALLED ❑2.DOUDLZ4ALLEQ ❑99,QTKER SYSTEMTYPE 1.PAESSDRE 2.GRAVITY l I3UNVENTtONALSUCTION 4.SAFE SUCr(ON IJ :R+Fm36(6D U9 PRIMARY CONTAINMENT I.STEEL 4.FIBERGLASS p S,FLEAIBLE Q 10.RIG(DPLAxM 4" Q 90.NONe ❑ 95.UNKNOWN ❑99.OTHER(SpeelN): a64 SEWNDARYOONTAINMENT Q ).STEEL El 4•PBEROLASS Ej 8,PLFVUULE 0 I0.RIGIDPLAST)C 4ua ❑90-NONE p 95-UNKNOWN ❑99.OTM(Spec4): Mae PIP(NO/TURBINR CONTAINMENT SUMP TYPB ❑ 1.SINGLEWALL ❑2,DOUDLG WALL ❑90,NONE 4sse VBNT,VAOR �(VR):ANDRjSER7.k"ILEPIEE.PdPfNGCOIYSTRIJCTION: A09 (Specily - - ° VENT RMAAYCANVTION. TMJ VENT SECONDARY CONTAINMENT ❑ I.STEEL, U 4MORO"M 13 (O.RIGHIPLASTtC IJ M-NON8 0 99.0THBR(Speeity) 46V 4Mn VR PRIMARY CONTA(NMIB9r 0 I.STREL, ❑ 4.FIBERGLASS Q XCAUGIDPLASTIC 90.NONE ❑99.OTHER(Sp 65 VR SECONDARY CONTAINMENT ❑ 1.STEEL 0 4.FIBEROLASS El 10.RIGIDPLASTIC ❑90.NONE ❑ 99.OTHER(SpetlTy) 464q 464x1 VENT PIPING TRANSITION5UMPTYPE I.SINGLE WALL 2-DOUBLE WALL 911.NONE 4M1, ' AISMPI IAAY CONTAINMENT I.STEEL 4•FU6EROLAS 10.R[GiD PLASTIC Q90.NONE 99.OTH8R(Spniry) 4Mi 46x1 LASER SECONDARY CONTAINMENT LSTREL ❑ 4.OBERGLASS IO.RIGIDPIASTICM-90-.-NO-NN-70 9R01HEA(Spmi&) a64a 4MYI ' %LLCQkWONENTStNSTALLSD ❑ 1.SPILLBUC - 3.9TRIKERPLATPI9OTTOMPROTECTOR 4.CONTAINMENTSUMP 451.s VIL UNDER DISPENSER CONTAINMENT C). CONSTRUCTION TYPE ❑ I.SINGLE WALL ❑S.DOUBLE WALL ❑3-NO DISPSNSERS ❑90.NONE 416% 1 CONSTRUCTION MATERIAL 1.STEEL ❑ 4.FIBERGLASS IO.RIGIOPLASTIC 99-OTHER(Spsd °esso VIII, CORROSIONTROTECI'ION ' STEELCOMPONSKMOTECIION ❑ LSACRIF(CrALANODE(S) p C IMPRESSED CURRENT Ll&ISOLATION aL UL APPLICANT SIGNATURE CERTIFICATION:I carNsy that N)(s UST system Is compAHble,with the hazardous substance stored and that the Information provided harem b true,accurate, and IR Pull WHIP11MCC wins h Al ry uiremantL APPLICANT SIONATURE DATE no. App CAM N E tinl) °I1' APP ANT TLE m' UPCF UST-P-1/2 R.,(1212007)